"Right to Palliative Care, Vulnerability Assessment & Review Board Key Pillars of PAD/VE Regime" Says Council of Canadians with Disabilities (CCD)

Media Release

January 28, 2016 │For Immediate Release

January 28, 2016 – While the SCC, in Carter, set aside the Criminal Code's total ban on assisted PAD/VE, CCD understands the SCC decision to mean that PAD/VE will only be provided after strict criteria, which are yet to be written into the Criminal Code, are met. Today, the Special Joint Committee on Physician Assisted Dying hears from Rhonda Wiebe and Dean Richert, who co-chair CCD's Ending of Life Ethics Committee. They will advise the Committee on how Parliament can seek to fulfill the Supreme Court of Canada's requirement to protect persons who are vulnerable and may be induced to commit suicide at a time of weakness, while allowing physician-assisted death and voluntary euthanasia (PAD/VE) for those who meet stringent criteria in a scrupulously monitored and enforced system. 

Vulnerability and suffering often go hand in hand.  Research shows that a wide range of factors associated with suffering can lead to a request for PAD/VE: race, ethnicity and culture; socio-economic deprivation and unemployment for both men and women; sexual orientation; major psychiatric symptoms and disorders; substance abuse; violence and abuse; family history of suicide; and onset of physical disability.  CCD holds that a person requesting PAD/VE may be in such a heightened state of vulnerability that other remedies should be offered before the person is given access to PAD/VE.

To address socially created vulnerability, CCD is calling for a vulnerability and capacity assessment process that will determine if a person meets the criteria established in Carter.  There was acknowledgement by the court that any set of safeguards must recognize the complex and sometime subtle and subconscious factors related to a PAD/VE request.  It is CCD's view that if vulnerability arises not from a terminal illness, then the evidentiary standard for the vulnerability not to have an impact on the request for PAD/VE must be a clear and convincing standard.  Otherwise, there is a very real risk that people will die in a manner that violates criminal prohibition.

To reduce vulnerability, Parliament also needs to enact legislation requiring the funding of palliative care.  Currently, palliative care is not covered under the Canada Health Act and only a minority of Canadians who need it, receive palliation.

CCD is urging that PAD/VE decisions not be made by a doctor behind closed doors in an exclusively medical context.  Instead, CCD is calling for the establishment of a nationally constituted Review Board, chaired by a federally appointed Judge.  Such a regime would ensure a national PAD/VE regime with Canada-wide standards, built upon the direction given in Carter. CCD is recommending against a patchwork of provincial and territorial standards. 

The Review Board would evaluate the vulnerability assessment, the assessment of two physicians and the patient's application and make the ultimate decision of whether a PAD/VE request would be granted. 

CCD is calling upon Parliament to revise the Criminal Code to specify the safeguards and criminal sanctions against assisted suicide, thus distinguishing between a legal request for PAD/VE and a criminal act.

-30-

For More Information Contact:
Dean Richert, Co-chair CCD Ending of Life Ethics Committee, Tel: 204-951-6273.
Rhonda Wiebe, Co-Chair CCD Ending of Life Ethics Committee, Tel: 204-779-4493.
James Hicks, National Coordinator, Tel: 343-291-1118.